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Insertion of expandable metallic stents in esophageal cancer without fluoroscopy is safe and effective: a 5-year experience.

AbstractBACKGROUND:
Self-expanding metallic stent (SEMS) placement is an important method of dysphagia palliation for patients with inoperable esophageal cancer. In most institutions, it is performed with fluoroscopic guidance; however, in 2001, we described a novel, direct-vision approach to SEMS placement, which does not require fluoroscopy. Here we report an audit of our experience over the last 5 years when using this methodology.
OBJECTIVE:
To describe our 5-year experience of 98 patients in whom esophageal stents were inserted when using the direct-vision technique and compare outcomes with published series of radiography-guided stents.
DESIGN:
Retrospective review of single-center experience.
SETTING:
English National Health Service Cancer Centre Hospital.
PATIENTS:
All patients who underwent esophageal stent insertion for a primary esophageal malignancy.
INTERVENTIONS:
SEMS insertion by direct endoscopic vision.
RESULTS:
Ninety-eight patients underwent SEMS insertion for malignant dysphagia during the study period, 92% of which were inserted without fluoroscopy. The technique had a low complication rate, which was consistent with published fluoroscopic data, and the median survival beyond stent insertion was 100 days (interquartile range, 62, 256; range, 4-921 days). In 59 patients, no further endoscopic palliative procedure was required.
LIMITATIONS:
Retrospective data collection.
CONCLUSIONS:
This series confirms direct-vision SEMS placement as a safe and efficacious method of malignant dysphagia palliation, providing definitive treatment in almost two thirds of cases.
AuthorsEmilie A Wilkes, Lucina M Jackson, Andrew T Cole, Jan G Freeman, Andrew F Goddard
JournalGastrointestinal endoscopy (Gastrointest Endosc) Vol. 65 Issue 6 Pg. 923-9 (May 2007) ISSN: 0016-5107 [Print] United States
PMID17466213 (Publication Type: Journal Article)
Chemical References
  • Metals
Topics
  • Adenocarcinoma (diagnostic imaging, therapy)
  • Aged
  • Aged, 80 and over
  • Deglutition Disorders (therapy)
  • Esophageal Neoplasms (diagnostic imaging, therapy)
  • Esophagoscopy
  • Female
  • Fluoroscopy
  • Humans
  • Male
  • Metals
  • Middle Aged
  • Palliative Care
  • Retrospective Studies
  • Stents
  • Treatment Outcome

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